Community pharmacy and primary health care - Types of integration and their applicability: A narrative review

• Published in: Research in social and administrative pharmacy 2023-03, Vol.19 (3), p.414-431
• Main Authors: Urionagüena, Amaia, Piquer-Martinez, Celia, Gastelurrutia, Miguel Ángel, Benrimoj, Shalom Isaac, Garcia-Cardenas, Victoria, Fernandez-Llimos, Fernando, Martinez-Martinez, Fernando, Calvo, Begoña
• Format: Article
• Language: English
• Subjects: Community pharmacy; Community Pharmacy Services; Delivery of Health Care; Humans; Integrated care; Integration; Pharmacies; Primary Health Care; Types of integration
• ISSN: 1551-7411; 1934-8150
• DOI: 10.1016/j.sapharm.2022.10.007

There is an urgent need for health care systems to be more efficient and efficacious. An approach to integrate public and private provider organizations such as community pharmacies and public primary health care (PHC) merits consideration. The objective of this review was to identify the types of integration in health care settings and discuss their applicability to the potential integration of community pharmacy and PHC. A narrative review using Medline, Scopus and SciELO databases was performed in which terms related to health were combined with terms related to integration. Levels and Types of integration: 14 types of integration were identified (two in breadth, seven as enablers and five in system levels). A model was created which classifies and assigns the types of integration to the different levels of the health system and to the breadth, intensity, and enablers of the integration process. Due to the nature of community pharmacy and PHC system, a horizontal integration at the micro level, supported by meso and macro levels policy, is suggested. The different elements of intensity and enablers can significantly influence the process. The application of principles, concepts and types of integration suggest that it might be feasible and practical to integrate community pharmacies and PHC. However, the conflictive historical context would need to be overcome with appropriate policy and incentives. •Health care systems would benefit by the incorporation of accessible community pharmacies.•Level of integration of community pharmacy in health care systems is limited.•14 types and 5 subtypes of integration in health were found.•A model which classified these as breadth, enablers and system is proposed.•Micro level horizontal integration with clinical and service integration is feasible.